臺灣博碩士論文加值系統

罹患嚴重精神疾病者整體犯罪率未較常人高，然而他國研究逕指出，精神疾病患者可能較常人有更高風險牽涉暴力犯罪。近年社會安全網資源積極佈建，暴力犯罪問題在國民法官法上路後亦為刑事司法體系著力要點。針對罹患精神疾病者之暴力犯罪關聯因子本土實證仍不足。本研究以司法單位委託行司法精神鑑定之犯罪者為樣本，檢驗以下假設：嚴重精神疾病、物質相關及成癮障礙症與暴力犯罪有顯著關聯；嚴重精神疾病與暴力犯罪的關聯受其他因子調節，包含性別、治療配合度、暴力犯罪史和合併物質相關及成癮障礙症。
本研究以民國98年10月至民國111年2月司法單位委託北部某精神醫療單位行司法精神鑑定之648位犯罪者為樣本，分析鑑定報告中之人口因子、臨床因子、司法精神鑑定關聯因子、暴力犯罪靜態因子和動態因子，以獨立樣本t檢定和卡方檢定進行雙變項分析，以多元邏輯迴歸分析暴力犯罪靜態因子和動態因子與暴力犯罪的關聯，最後檢驗性別、暴力犯罪史、治療配合度不佳、合併物質相關及成癮障礙症等因子對嚴重精神疾病與暴力犯罪關聯的調節作用。
本研究樣本79.0%為男性，90.1%無業，90.9%單身，17.3%過往從未接受過精神科評估，92.4%治療配合度不佳。檢察官起訴罪名中，30.6%是竊盜案件，14.5%為妨害性自主、10%是公共危險罪，5.4%為殺人案件，4.2%為詐欺。與非暴力犯罪者相比，暴力犯罪者較可能為男性、犯案從未接受過精神科評估者比例較高，嚴重精神疾病、物質相關及成癮障礙症、單身狀態、失業狀態、治療配合度不佳與暴力犯罪則未有顯著關聯。性別、治療配合度、暴力犯罪史和合併物質相關及成癮障礙症等因子對嚴重精神疾病與暴力犯罪的關聯亦沒有顯著的調節作用。
本研究建議未來針對精神疾病者相關事件，媒體應審慎報導，減少汙名；刑事司法體系應與司法精神鑑定團隊共同努力，朝向鑑定報告內容精緻化，處遇個別化之目標；未來針對罹患精神疾病犯罪者之需求，刑事司法體系及其他網絡應儘可能給予當事人周延的計畫，安排就醫，持續治療，協助更生。

The overall crime rate among individuals with severe mental illnesses is not higher than that of the general population. However, some studies imply that individuals with mental illnesses may be at a higher risk of involvement in violent crimes. There remains a lack of local empirical research on the factors associated with violent crime among individuals with mental illnesses. This study adopts a sample of offenders referred for forensic psychiatric assessments from criminal justice system to examine the following hypotheses: there is a significant association between severe mental illness, substance-related and addictive disorders, and violent crime; the association between severe mental illness and violent crime is moderated by factors such as gender, treatment compliance, history of violent crime, and comorbid substance-related and addictive disorders.
This study analyzed 648 offenders who were referred for forensic psychiatric evaluations at a northern psychiatric medical unit between October 2009 and February 2022. The demographic factors, clinical factors, forensic factors, and static and dynamic factors of violent crime were analyzed using independent samples t-tests and chi-square tests for bivariate analysis, and multivariate logistic regression was used to examine the associations among static, dynamic factors and violent crime. Finally, the moderating effects of gender, history of violent crime, poor treatment compliance, and comorbid substance-related and addictive disorders on the association between severe mental illness and violent crime were tested.
The sample consisted of 79.0% males, 90.1% unemployed, 90.9% single, 17.3% had never received a psychiatric evaluation, and 92.4% had poor treatment compliance. Among the charges filed by prosecutors, 30.6% were theft cases, 14.5% involved sexual offenses, 10% were offenses against public safety, 5.4% were homicide cases, and 4.2% were fraud cases. Compared to non-violent offenders, violent offenders were more likely to be male and had a higher proportion of never having received a psychiatric
evaluation at the time of the offense. Severe mental illness, substance-related and addictive disorders, single status, unemployment status, and poor treatment compliance were not significantly associated with violent crime. Furthermore, factors such as gender, poor treatment compliance, history of violent crime, and comorbid substance-related and addictive disorders did not significantly moderate the association between severe mental illness and violent crime.
This study suggests that media reports on incidents involving individuals with mental illnesses should be cautious to reduce stigma. The criminal justice system should collaborate with forensic psychiatric specialists to refine the content of evaluation reports and aim for individualized treatment plans. The criminal justice system and other specialists should provide comprehensive plans, continuous treatment, and rehabilitation assistance for offenders with mental illnesses.

第一章 緒論 1
第一節 研究動機與目的 1
第二節 相關名詞解釋 7
第二章 文獻探討 11
第一節 思覺失調類群和其他精神病症與暴力犯罪 12
第二節 雙相情緒及其相關障礙症與暴力犯罪 17
第三節 憂鬱症與暴力犯罪 19
第四節 物質相關及成癮障礙症與暴力犯罪 21
第五節 認知類障礙症與暴力犯罪 25
第六節 人格障礙症與暴力犯罪 26
第七節 智能不足與暴力犯罪 28
第八節 暴力犯罪關聯因子 29
第九節 司法精神鑑定 30
第三章 研究方法 34
第一節 研究架構 34
第二節 研究假設 37
第三節 研究對象 38
第四節 研究變項 40
第五節 統計使用方法 48
第六節 研究倫理 50
第四章 研究結果 51
第一節 變項描述性統計 51
第二節 第一部分分析：「本土官方定義」之暴力犯罪者和非暴力犯罪者 54
第三節 第二部分分析：「國際廣義定義」之暴力犯罪者和非暴力犯罪者 59
第四節 第三部分分析：「殺人」和「竊盜」 64
第五章 結論與建議 69
參考文獻 80

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